Offer Form A (In Accordance With Commodity Exchange No. 7i) (Page 2 of 2) in pdf

Offer Form A (In Accordance With Commodity Exchange No. 7i) Page 2

Page 2 of 2

Part Two - CCC Receives From Offeror:

Total quantity CCC is to receive:

300 Metric Tons

Commodity and pack size:

Vegetable Oil packaged in 6/4 Liter Round Tins

Shipped to CCC approved location:

Location A: _____________________________

Location B: _____________________________

Location C: _____________________________

If Offeror requires more delivery locations, please submit an additional

offer form

Shipment Period:

December 16 - 31, 2007 for inland plants

January 1 - 15, 2008 for plants located at the port

SIGNATURE _____________________________

TITLE_______________________________

PRINTED NAME__________________________

The following statements are made in accordance with the Privacy Act of 1974 (5 USC 552a) and the Paperwork Reduction Act of 1995, as amended. Furnishing the

requested information is required to be a responsive offer. Failure to furnish the requested information will result in a non-responsive offer. This information may be

provided to other agencies, IRS, Department of Justice, or other State and Federal Law enforcement agencies, and in response to a court magistrate or administrative

tribunal. The provisions of criminal and civil fraud statutes, including 18 USC 286, 287, 371, 641, 651, 1001; 15 USC 714m; and 31 USC 3729, may be applicable to the

information provided.

Federal agencies may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control

number. Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions,

searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this

burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U. S. Department of Agriculture, Clearance

Officer, OIRM (OMB No. 0560-0177), Stop 7630, Washington, D.C. 20250-7630.

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, gender, religion, age,

disability, political beliefs, sexual orientation, and marital or family status. (Not all prohibited bases apply to all programs.) Persons with disabilities who require

alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA's TARGET Center at (202) 720-2600 (voice and

TDD).

To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 14th and Independence Avenue, SW, Washington, D.C.

20250-9410 or call (202) 720-5964 (voice or TDD). USDA is an equal opportunity provider and employer.

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